Established on July 30, 1965 by the federal government, Medicaid is the nationwide health coverage program for individuals with low income, including children, adults with disabilities and the elderly. It provides coverage for essential health services, such as primary physician care, hospitalization, emergency and long-term care.
Medicaid is administered at the state level, and each state has the option to provide additional, optional benefits through state-specific Medicaid waivers and programs.
In Florida, seniors aged 65 and older who collect Supplemental Security Income benefits are automatically eligible for SSI-Related Medicaid coverage and only need to complete further screening when requesting long-term care services.
Qualifying for Florida Medicaid
All other seniors must meet income, asset and residency guidelines as follows:
- Be a U.S. citizen, U.S. national, permanent resident or legal alien
- Live full-time in Florida
- Earn no more than $2,313 per month when applying as a single, or
- Earn no more than $4,626 per month in joint income when applying with a spouse, and
- Own no more than $2,000 in countable assets as an individual, or
- Own no more than $3,000 in joint countable assets when applying with a spouse
Some assets are not countable under Medicaid rules, such as an irrevocable burial contract, one vehicle and household furnishings. A house, condo or mobile home that is owned and occupied by the applicant and/or their spouse is also not counted as long as it’s assessed value is $585,000 or less.
If only one spouse needs long-term Medicaid services, the income of the community spouse isn’t counted. The community spouse is also eligible to keep up to $126,420 of the couple’s joint assets.
Qualified Income Trust Seniors who are ineligible for Medicaid because their monthly income exceeds Medicaid limits may qualify for enrollment by using a
Qualified Income Trust.
Also known as a Miller Trust, a QIT is an irrevocable trust in which the state is named the beneficiary. Seniors must agree to place all of their income that exceeds Medicaid limits, less money spent on approved medical expenses, into the QIT. Upon death, any money the state has paid towards the seniors’ care costs will be withdrawn from the QIT before any disbursements are made to the estate.
For more information on Florida Medicaid and the QIT program, visit the
Osceola County ACCESS Storefront or phone the ACCESS customer call center at (866) 762-2237.
Statewide Medicaid Managed Care Long-Term Care Program Florida seniors aged 65 and older who qualify for long-term Medicaid and meet the clinical criteria for nursing home placement may be enrolled in the
Statewide Medicaid Managed Care Long-Term Care Program. This nursing home diversion program provides enhanced home and community-based services that let frail seniors age in place in an assisted living facility.
In accordance with federal law, all Medicaid participants who request long-term care services must be assessed by the
Comprehensive Assessment and Review for Long-Term Care Services program. It’s performed by a registered nurse or designated assessor to determine the most appropriate, least-intrusive placement for each applicant.
Seniors referred to the SMMC LTC program are assigned services based on their specific needs, and these services may include:
- Adult day programming
- Assistance with activities of daily living
- A medical alert system
- Housekeeping and laundry
- Skilled and intermittent nursing
- Medical supplies and mobility equipment
- Transportation
- Hospice services
- Physical therapy
- Speech therapy
- Case management
For more information on the SMMC LTC or to request a CARES assessment, contact the statewide Elder Helpline at (800) 963-5337.